〔Abstract〕 The paper elaborates the devolopment background of malignant tumor main diagnosis ICD selection module, embeds this module into Electronic Medical Records ( EMR) ystem, introduces design basis, principles and ideas, analyzes the operation process and module functions.It also points out that this module could assist doctors to fill in the diagnostic information of malignant tumor pa-tients, provide better services for clinical, scientific research and management through examples.

Diabetes mellitus( DM)affects almost the whole digestive tract. Approximately 75% of the diabetic patients suffer from gastrointestinal motility disorders. The precise mechanism of diabetic gastrointestinal motility disorders is not fully clear. Its pathogenesis is considered to be multifactorial and related with autonomic neuropathy,smooth muscle myopathy and lesions of interstitial cells of Cajal. Advanced glycation end products( AGEs ) are derived from the nonenzymatic reaction of glucose with proteins,lipids or nucleic acids in vivo. Hyperglycemia in DM is a favourite for formation of AGEs, and excessive accumulation of AGEs contributes to the complications of DM such as diabetic nephropathy and diabetic vascular lesions. However,the correlation of AGEs with diabetic gastrointestinal motility disorders is seldom reported. In this review article,the roles and possible mechanisms of AGEs in diabetic gastrointestinal motility were summarized.

The authors analyzed the current predicament of medical human resources and seek the deficiencies and problems that exist in the medical moral education system .Based on this , this paper pointed out that it should change the medical ethics education ideas , enhance medical ethics cultural identity; based on the health industry demand , broaden the content of the medical ethics education;to develop a new mode of medical ethics education , perfect the evaluation system of medical ethics and health industry demand , provide new guidance for medical eth-ics education .

Objective] To establish the quality evaluation of col ege entrepreneurship education. [Methods] Based on the relevant research at home and abroad,this paper establishes the quality evaluation index system of col ege entrepreneurship education, and AHP is applied to weigh the grade assessment indexes. [Results] This paper constructs a comprehensive evaluation index system ,including 4 first level indexes, 10 second level indexes, 40 third level indexes. The first level indexes are the course, the teachers, the students and the environment. The weight of those indexes separately is 0.0938,0.1745,0.5086,0.2231 respectively. [Conclusion]This paper provides the basis of constructing a perfect quality evaluation system of col ege entrepreneurship education,which is of positive significance to provide policy basis.

Objective To assess the efficacy and adverse reactions of two cconcentrations of diluted botulinum toxin A for dynamic frontotransverse wrinkles.Methods Totally 103 cases met the inclusion criteria were assigned into two groups by a random number table:high concentration group (50 U/ml,53 cases) and low concentration group (25 U/ml,50 cases).The two groups were given the local injection with 50 U/ml and 25 U/ml concentration of botulinum toxin type A,respectively.Dosage of BTX-A,the treatment effect,the duration of the effect and the incidence of adverse reactions were analyzed.Results The high concentration group were given the BTX-A (45.53±2.05) U,the low concentration group were given the BTX-A (25.71 ± 1.74) U,and the difference were statistically significant (P＜0.05).The differences of post-operative evaluation,time of onset and duration between the two groups were not statistically significant (P＞0.05).In the high concentration group,30 cases (88.24％) had forehead heaviness sensation,and 2 cases (5.71％) in the low concentration group,the difference were statistically significant (P＜0.01).Neither of the groups was given any specific treatment,the symptoms were disappeared in two weeks.In either group there was no serious complications such as intoxication,allergy,etc.Conclusions The efficacy of local injection with two concentrations of diluted botulinum toxin A in the treatment of dynamic frontotransverse wrinkles is positive,the duration of treatment effect between the two groups is similar,and therefore the 25 U/ml concentration is recommended to reduce the forehead heaviness sensation.

This study aimed to explore clinical features of multiple myeloma in patients over 80 years old. Methods: We retrospectively analyzed 11 cases of multiple myeloma over 80 years old, which were diagnosed from 2000 to 2013 in our hospital. Results:The mean age was 83.5 years. All patients had more than two complicated diseases, and the performance status was poor in the majority of the patients. Ten cases received individualized treatments. The results showed that three patients had progressed, one patient achieved complete remission, three patients achieved partial remission, and four patients achieved minor remission. Median survival time was 28 months. The causes of death included six progressed myelomas, three pneumonias, and two acute myocardial infarctions. Conclusion: Patients aged 80 years old with myeloma are often at a late stage. Treatment should be individualized based on patient status. Survival time was evidently prolonged in very elderly patients with MM after individualized treatments, particularly in patients in stagesⅠandⅡ.

Objective To discuss the application and effect of sufentanil combined with propofol on painless gastroscopy anesthesia.Methods In the fourth people's hospital of Zhejiang in April 2014-June 2016,94 cases treated with painless gastroscopy I were randomly divided into two equal groups.Anesthesia group A were anaesthetized with fentanyl and propofol,sufentanil and propofol for anesthesia group B.The anesthetic effect,the time of consciousness disappearance,eye opening time,recovery time of orientation,the dosage of propofol in the two groups were compared.The mean arterial pressure,heart rate and adverse reaction rate in the two groups were compared.Results The anesthetic effect in the anesthesia groupB is significant better than that in the anesthesia group A(P<0.05).Compared with the anesthesia groupA,the time of consciousness disappearance,eye opening and orientation recovery is shorter in the anesthesia groupB(P<0.05),The difference of the mean arterial drug Pressure and heart rate is not significant in the two groups before medication.After medication and wake up,compared with the anesthesia group A,the mean arterial pressure,heart rate fluctuation is smaller,and the adverse reaction rate is lower in the anesthesia group B,(P<0.05).Conclusion It is effective which sufentanil combined with propofol used in anesthesia in painless gastroscopy,It can stable vital signs of patients during operation,,work quickly,restore consciousness rapidly,and contribute to reduce complications,and is worthy of promotion.

If loosely defined,an abscopal effect occurs when localized irradiation affects the whole organism.In recent years,distant tumor regression and normal tissue damage after localized irradiation have been concerned by immuno-oncologists.However,the mechanisms of this effect are still far from clear.Mounting evidences suggest that the generation of abscopal effects is closely related to immune regulation.Radiotherapy might become a systemic tumor-treatment modality by enhancing immune function and played an important role in every stage of tumor development and prognosis.For the moment,targeting the immune checkpoint has become an attractive approach for malignant tumor therapy.Preclinical data have revealed that a strong abscopal effect could be effectively induced by the co-treatement of immune checkpoint inhibitors and irradiation,which could recruit antitumor T cells and achieve a powerful antitumor effect.This review discusses current progress and perspectives of abscopal effects in the combination of radiotherapy and immunotherapy.

Objective:To improve the work of drug quality sampling and testing. Methods:The regulation of testing related work in Drug Quality Sampling and Testing Regulation was analyzed and discussed. Results and Conclusion: Some suggestions were pro-vided in order to improve the regulation of testing work in Drug Quality Sampling and Testing Regulation.

Autophagy is a physiological process which delivers the mutant cytoplasmic proteins and dysfunctional subcellular organs into lysosomes for degradation to generate fuel in the deficiency conditions. It is mainly classified into macroautophagy, microautophagy and chaperon-mediated autophagy (CMA), as well as the selective autophagy such as mitophagy and aggrephagy. This review mainly introduces the key molecular markers of macroautophagy, CMA and mitophagy.